<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>Documento sin t&iacute;tulo</title>
<link href="css/bootstrap.css" rel="stylesheet">
<link href="css/bootstrap-responsive.css" rel="stylesheet">
 <style type="text/css">
      body {
        padding-top: 40px;
        padding-bottom: 40px;
        background-color: #f5f5f5;
      }

      .form-signin {
        max-width: 900px;
        padding: 19px 29px 29px;
        margin: 0 auto 20px;
        background-color: #fff;
        border: 1px solid #e5e5e5;
        -webkit-border-radius: 5px;
           -moz-border-radius: 5px;
                border-radius: 5px;
        -webkit-box-shadow: 0 1px 2px rgba(0,0,0,.05);
           -moz-box-shadow: 0 1px 2px rgba(0,0,0,.05);
                box-shadow: 0 1px 2px rgba(0,0,0,.05);
      }
      .form-signin .form-signin-heading,
      .form-signin .checkbox {
        margin-bottom: 10px;
      }
      .form-signin input[type="text"],
      .form-signin input[type="password"] {
        font-size: 16px;
        height: auto;
        margin-bottom: 15px;
        padding: 7px 9px;
      }

    </style>
	</head>


<body>

<form class="form-signin">
  <table width="410" border="0" align="center">
      <tr>
      <td colspan="2"><div align="center" class="Estilo1">
        <h2>Ingresar Usuario </h2>
      </div></td>
    </tr>
  <tr>
    <td height="300" align="left" valign="top"><form id="form1" name="form1" method="post" action="">
        <table width="359" border="0" align="left">
          <tr>
            <td width="129"><span class="Estilo4">Nombres y Apellidos: </span></td>
            <td width="214"><input name="textfield" type="text" size="40" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Documento de Identidad: </td>
            <td><input name="textfield2" type="text" size="8" maxlength="8" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Correo Electronico: </td>
            <td><input name="textfield3" type="text" size="35" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Contrase&ntilde;a:</td>
            <td><input name="textfield4" type="password" size="15" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Sexo:</td>
            <td><select name="select">
              <option>Femenino</option>
              <option>Masculino</option>
            </select>            </td>
          </tr>
          <tr>
            <td class="Estilo4">Telefono Movil: </td>
            <td><input name="textfield5" type="text" size="10" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Direccion:</td>
            <td><input name="textfield6" type="text" size="40" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Distrito:</td>
            <td><select name="select5" size="1">
              <option selected="selected">Ate</option>
              <option>Cercado</option>
              <option>Carabayllo</option>
            </select>
            </td>
          </tr>
          <tr>
            <td class="Estilo4">Fecha de Nacimiento: </td>
            <td><input name="textfield8" type="text" size="10" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Tipo de Tarjeta: </td>
            <td><select name="select2">
              <option>Tarjeta de Credito</option>
              <option>Tarjeta de Debito</option>
            </select>            </td>
          </tr>
          <tr>
            <td class="Estilo4">Codigo de Verificacion: </td>
            <td><input name="textfield9" type="password" size="15" /></td>
          </tr>
          <tr>
            <td class="Estilo4">Entidad Bancaria: </td>
            <td><select name="select3">
              <option>Banco de Credito</option>
              <option>Interbank</option>
              <option>Banco BBVA</option>
            </select>            </td>
          </tr>
          <tr>
            <td class="Estilo4">Tipo de Perfil: </td>
            <td><select name="select4">
              <option>Administrador</option>
              <option>Usuario</option>
            </select>            </td>
          </tr>
        </table>
        </form>      </td>
  </tr>
  <tr>
  <td colspan="2">
        <div align="center">
		  
        <!--  <input name="Submit" type="submit" value="Guardar" />      -->  
		<a class="btn btn-large btn-success" href="#">Guardar</a>      
          <!--   <input type="submit" name="Submit2" value="Salir" />      -->  
      <a class="btn btn-large btn-success" href="#">Salir</a>        </div>        
	 </td>

  </tr>
</table>
</form>
</body>
</html>
